Nutritional Needs for Breast Health

The lifetime risk of breast cancer in US women is 1 in 8, with risk increasing with each decade.

For a woman in her 30s, the risk is only 1 in almost 1,500.

 By the age of 50 it is 1 in 42. 

Between the ages of 70 and 80, which is the highest risk decade, the risk is are 1 in 33. 

The median age of diagnosis is 62 years of age and 95% of cases occur in women over the age of 40. 

Unfortunately, some risk factors cannot be changed.  These include being female, aging, and family history. 

Eighty-seven percent of breast cancer diagnoses occur in women without a first degree relative with breast cancer.  Only 8-10% of cancers are inherited. 

 

What risk factors can be changed?

Weight

Fat cells produce estrogen.  High estrogen levels after menopause increase your risk of breast cancer.  Women with obesity have a higher risk of breast cancer, breast cancer recurrence, and breast cancer-related deaths. 

The risk of breast cancer increases with more weight gained after menopause.  For women gaining more than 29 pounds, the relative risk is 1.9.

Women with breast cancer who gain weight during or after their treatment increase their risk of recurrence and reduce their survival fivefold.  This is irrespective of weight prior to treatment.

Alcohol

Alcohol increases estrogen levels, forms acetaldehyde, impairs immune function, and interferes with DNA repair. 

Relative risk increases with increased daily consumption of alcohol on a regular basis.

Exercise

Exercise decreases the risk exponentially.  The more vigorous and longer the exercise, the less the risk. 

Four hours a week of moderate to vigorous exercise will lower your incidence of breast cancer by almost 60%.

Social Connection

Social connection is key for breast cancer survivors.  Increased mortality is seen in woman who have low levels of social support.

Depression, tobacco, chemical exposure, poor sleep quality and duration, and adverse childhood events are also associated with a higher risk of cancer. 

Nutrition

Whatever we put in our mouth has the potential to alter the following:  levels of estrogen, other growth factors, inflammatory markers, immune system function, free radical formation, and the potential for new blood vessel formation to tumor cells.

Ultimately, food is medicine, depending on what we eat.   

Oxidative stress is an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage.  The body’s cells produce free radicals during normal metabolic processes.  Several factors contribute to oxidative stress and excess free radical production including diet, lifestyle, chronic diseases, inflammation, and environmental pollution.

Antioxidants neutralize free radicals and counteract against oxidative stress.

Plants, herbs, and spices contain a variety of phytonutrients and antioxidants that help combat oxidative stress.  Examples include, turmeric, resveratrol found in red grapes, procyanidins in berries, EGCG in green tea, and omega-3 fatty acids found in seeds, nuts, and avocados.

Pro-inflammatory foods, such as highly processed foods, saturated fat, refined sugar, processed meat, and red meat, have been associated with an increased risk of breast and colon cancer. 

Why? Processed foods result in exposure to chemical additives and contaminants and increase the propensity for obesity, chronic inflammation, and oxidative stress.

Higher levels of animal protein lead to increased risk of cancer, cancer death, diabetes, and all-cause mortality.  Postmenopausal women who eat processed and red meat have a 25% increased risk of breast cancer.

Well-done meat is of particular concern.  Heating any meat (including chicken or poultry) creates polycyclic aromatic hydrocarbons and heterocyclic amines.  This is due to an interaction between heat and the creatinine found in muscle. 

Excess levels of IGF-1 are seen with animal fat and protein consumption.  IGF-1 is a hormone that manages the effects of growth hormone in your body.  Together, IGF-1 and growth hormone promote normal growth of bones and tissues.  However, high levels of IGF-1 are known to promote cancer development by inhibiting apoptosis (cell death) and stimulating cell growth. 

Women with IGF-1 concentrations in the top 20% have a 1.24-fold increased chance of developing breast cancer. 

Laron syndrome is characterized by the absence of IGF-1 receptors.  There is a population of women in Equador with Laron syndrome.  While they are short, there are no cases of breast cancer to be found.  In fact, over years, there has only been one woman who had any type of cancer.  Interestingly, they also have zero incidence of diabetes.  

Several diets were studied in The Adventist health study.  These included meat eaters, vegans, and variations of vegetarians, such as pesco vegetarians (fish eaters), lacto ovo vegetarians (dairy and egg eaters), and those who were vegetarian part of the time.  The vegan diet was the only subgroup to show a statistically significant decrease in cancer risk.  A plant-based diet decreases IGF-1, inflammation, and increases fiber intake.

Fiber helps filter excess estrogen from bile, thus decreasing circulating estrogen levels.  Consumption of 30 grams of fiber daily decreases risk by 50%.

Dietary fat has also been shown to increase risk.  In the women’s intervention nutrition study, postmenopausal women with breast cancer placed on a reduced fat diet had a significant reduction in cancer recurrence.

What about dairy?  Estradiol can be measured in dairy, and levels of estradiol are seen in the urine after consumption. 

Why?  Because cows only produce milk when they are impregnated.  Thus, their higher levels of circulating hormones, i.e., estrogen & IGF-1, are found in their milk.  This is irrespective of whether the cow was given steroids. 

The Adventist Health Study found a 50% increased risk of breast cancer in women with a higher intake of cow’s milk.

One study found that in women with a history of breast cancer, having just one serving a day of dairy increased their mortality risk by almost 50%.

Fruits and vegetables?  A decreased risk of breast cancer is seen in women who eat more servings of fruits and vegetables and are physically active.  Women who eat less plants and don’t exercise fair the worst.

What about soy?  Numerous studies have shown a decreased risk of breast cancer with consumption of soy, including in women with the BRCA gene mutation.

Less breast cancer recurrence is also seen with the consumption of soy. 

Why? Soy contains a high concentration of isoflavones, a type of plant estrogen (phytoestrogen) that is similar in function to human estrogen but with much weaker effects. Soy isoflavones can bind to estrogen receptors in the body and cause either weak estrogenic or anti-estrogenic activity.

Studies that observe women consuming soy foods over time show either a protective or neutral effect on breast cancer risk. Women from Asian countries appear to receive greater protective benefit from breast cancer with high soy intakes than American and European women.

This is likely due to differences in the gut microbiome. Asian women may have higher levels of equol, a metabolized substance of soy created by specific bacterial flora in the intestines. Equol is believed to block potentially negative effects of human estrogen. Higher levels of these particular bacteria appear to be present in individuals who consume soy foods starting at an early age. It is estimated that 30-50% of all humans are able to produce equol.

The less processed the soy the better (edamame, soybeans).  More processed forms of soy (soy protein isolate, textured soy protein, soybean oil) are less beneficial.

Possible Supplementation to Decrease Risk of Developing Breast Cancer or Recurrence of Breast Cancer

·        Vitamin D.  Women with low levels of vitamin D have a higher risk of breast cancer.  Also, women with low levels at the time of diagnosis have a lower survival rate.  Vitamin K2 taken with vitamin D may help with bone density.

·        Folate

·        Vitamin B6

·        Curcumin (turmeric) and piperine (black pepper)

·        Antioxidants

·        Omega 3 fatty acids

·        Vitamin C

·        Melatonin (low dose)

Ten Breast Super Foods

·        Cruciferous & leafy green vegetables

·        Dietary Fiber

·        Berries

·        Apples

·        Tomatoes

·        Mushrooms

·        Galic, Onions, Leeks, Shallots

·        Turmeric and spices

·        Seaweed

·        Cacao

 

Foods that have the highest cancer preventive potential per the American National Cancer Institute include garlic, soy, ginger, licorice, umbelliferous vegetables (carrots, celery, parsley, parsnips). 

Foods with moderate ability are onions, flaxseed, citrus, turmeric, cruciferous vegetables, solanceous vegetables (tomatoes, peppers), brown rice, and whole wheat. 

 

Eat more plant-based whole foods, maintain a healthy weight, stay connected, and exercise.

 

Novel Nutrition DURING Breast Cancer Treatment

The ketogenic diet has emerged as a potential adjunct treatment option for a variety of cancers, including breast cancer.  Tumor cells are reliant on glucose for survival and growth.  A ketogenic diet lowers the level of glucose and insulin in the blood, resulting in antitumor effects.  Since the keto diet includes very minimal carbohydrates, the body’s metabolism shifts toward burning fat rather than glucose.  Ketone bodies are fatty acids created in the liver to supply energy when glucose is in short supply.

Another novel treatment involves a 5-day fasting mimicking diet.  Repeating the fast during chemotherapy treatments has been shown to decrease tumor size and improve response.

Antioxidant supplementation during treatment has been associated with a higher recurrence rate.  Antioxidants may decrease the efficacy of chemotherapy.

The nutritional needs of people with cancer vary from person to person. Your cancer care team can help you identify your nutrition goals and plan ways to help you meet them. 

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